| NPI | 1578303012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA20516) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WI 7898-23) |
| Enumeration Date | 2024-05-31 |
| Last Update Date | 2026-08-18 |